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Aug 2011

A Bonelike Protrusion on the Toe —Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(8):975-980. doi:10.1001/archdermatol.2011.195-b

Plain radiograph showed irregular exostosis arising from the dorsal surface of the distal phalanx of the right second toe, suggesting subungual exostosis or other osteoid matrix-forming masses (Figure 2). Histopathologic examination of the biopsy specimen demonstrated well-formed mature bony trabeculae of the cortical type with minor portion of woven bones, rimmed by active osteoblasts in the background of fibrocollagenous proliferation (Figure 3 and Figure 4). The osseous trabeculae were distributed haphazardly with an incomplete zoning pattern. In some areas,the fibroblasts were loosely scattered within a prominent myxoid matrix and were admixed with foci of osteoids and bony trabeculae. There was no evidence of cellular atypia, nuclear pleomorphism, or abnormal mitotic figures. These findings were consistent with FOPT, and the lesion was treated by local excision without recurrence.

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